Provider Demographics
NPI:1740862697
Name:SARSHAR, ALI
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:SARSHAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 KINGSLEY RD SW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6444
Mailing Address - Country:US
Mailing Address - Phone:703-906-2664
Mailing Address - Fax:703-991-0840
Practice Address - Street 1:509 KINGSLEY RD SW
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-6444
Practice Address - Country:US
Practice Address - Phone:703-906-2664
Practice Address - Fax:703-991-0840
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-212503374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide